Prognosis of Ruptured Cerebral Aneurysms with Retinal Hemorrhage

Abstract

564 patients with subarachnoid hemorrhage caused by ruptured cerebral aneurysm were studied statistically with a correlation between retinal hemorrhage (RH) and outcome. Of these, 142 patients (or 25%) exhibited RH. No correlation was demonstrated between the frequency of RH and age or sex. Unilateral RH was seen in 34 patients with middle cerebral artery or internal carotid artery aneurysm and out of them, 25 patients (or 74%) had RH in the aneurysm side. The mortality rate of the patients with RH was 35% which is higher than that of patients without RH (13%). Of the 93 survivors with RH, 68 patients (or 73%) required daily-care. In contrast, out of 367 survivors without RH, 124 patients (or 34%) required daily-care. There was a significant correlation between the severity of RH and survival rate or activities of daily living, although there was no difference in the outcome between the patients with unilateral and bilateral RH. There were 15 cases (or 2.7%) with Terson's syndrome (TS). The mortality rate of patients with TS was 20% and all of the 12 survivors required daily-care. It is concluded that ruptured cerebral aneurysms with RH show a poorer prognosis than those without RH.